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, � <br /> � "- ' SEPTIC SYSTEM APPROVAL <br /> � ��;�; � �'� �v��,� <br /> O � � <br /> � � <br /> � �.� ' 1 ��� � � <br /> � :. � <br /> -..:. . . � �i���� o�o�o <br /> ,,,.., t �; ,_ � �' <br /> ` � � <br /> �\ � ' , � �l�,// Municipal Offices <br /> �� � ,' G �� Strzet Address: �iailinQ Address: <br /> � '��'��� � �;�'�':,%" � ' <br /> ��Eg�p � 2750 Kelley Parkway P.O. Box 66 <br /> Orono, MN 55356 Crystai Bay, MN 5532'-0066 <br /> Owner �,c���G hl,`lli;��+�5 Phone (Home) (Work) <br /> Address �3yG 6f'^ �v� City �2cn;i,i State �1,�i Zip <br /> Site Evaluator 5-P i�s��'n n State License# 3� Phone# �l9 7-,3�b 6 <br /> Type of Establishment: Single Family x Multi Family <br /> Commercial /�e Garbage Disposal Yes No <br /> No. Potential Bedrooms � Est. Gallons Per Day y S� <br /> Water Meter Required: Yes No� Soil Sizing Factor . 8:3 ;YS � _ F- z <br /> Perc Rates P-1 r'3;'Z P-2 �, P-3 P-4 P-5 P-6 <br /> Restricting Layer Depth B-l� B-2 22" B-3 2�" B-4 B-5 B-6 <br /> Type of Treatment System: <br /> Standard_� Experimental Alternative <br /> Pressurized Mound System X_ At-Grade System <br /> Gravity Trenches System Pressurized Trench System <br /> Gravity Trenches W/Lift Pressurized Bed System <br /> Holding Tank W/Alann <br /> Septic Tank Size � 0 a/ Sc�-' •:l #of Tanks 2 Lift Tank Size !c,�D" <br /> Pump Brand �- "�"���R;GPM ,�?�j Head 2y <br /> Treatmen� System: <br /> Minimurt�jp X 37' .� �{2��� Square Feet with � inches of rock below pipe <br /> Type of covering abric�_ Other � <br /> THIS IS NOT A PERMIT. This is a design approval form which must accompany the site plan. <br /> A permit must be issued to a licensed septic contractor prior to installation. <br /> NOTICE TO INSTALLERS: Any changes to the approved plans must have prior approval of the <br /> inspector(249-4600) Call for inspection 24 hours in advance. <br /> ALL DRAINFIELD AREAS MUST BE FENCED OFF prior to building site excavation and <br /> . fencing must remain in place until final site grading. Approval to pour footings will not be granted <br /> until the Inspections Department has verified the primary and alternate sites are protected. <br /> NO VEHICULAR TRAFFIC OF ANY KI'vD is allowed within 20'of tested drainfield sites ever. <br /> ACCEPTED X DEI�tIED By the City of Orono subject to existing regulations and <br /> the follo�vina conditions:�,',/� �J�b�,� �; S�� s�t-6�•� te �,e�l, �`s�r,��k- f� �tF;vi�l�o�'s c�e�l �u{ <br /> �� 'f"C 'QSf �( — -- �/)Yl!�� ` cS( ��' ri'9 - . � ' t� L1C�L1��( <br /> w�1( (Q.L �,��,f �c,�;.1� 'FGu.uJ S�=� �'�+cics. � <br /> � By: �:� -�'�Gz <br /> C ' ence, On-Site Systems Manager <br /> Telephone(612)249-4600 • Fax(612)249-4616 <br />